To better understand surgeon preference when using synthetic, absorbable, monofilament
suture by comparing two similar appearing FDA-approved sutures, Monosyn (Aesculap) and
Physicians have used suture to close wounds for at least 4,000 years. Archaeological records
from ancient Egypt show that Egyptians used linen and animal sinew to close wounds. In
ancient India, physicians used the pincers of beetles or ants to staple wounds shut. They
then cut the insects' bodies off, leaving their jaws (staples) in place. Other natural
materials used to close wounds include flax, hair, grass, cotton, silk, pig bristles, and
The fundamental principles of wound closure have changed little over 4,000 years.
Successful closure of wound involves surgical techniques coupled with knowledge of the
physical characteristics and handling of the suture and needle. The selection of proper
suture material in closing any surgical defect is important in wound healing, minimizing
infection, and achieving optimal cosmetic and functional results.
A great deal of progress has been made since Egyptian times with regard to suture materials
and manufacturing processes. Today, sutures are available with a wide variety of
characteristics, configuration, manipulability, coefficient of friction, solubility,
strength, and immunogenic properties. Yet, sutures are currently rather crudely classified
based on a numeric scale according to diameter and tensile strength; descending from 10 to
1, and then descending again from 1-0 to 12-0. This study aims to explore the factors that
are important to a surgeon when choosing sutures via evaluating surgeon preference for two
types of synthetic, absorbable, monofilament sutures: Monosyn and Monocryl. We hope to
initiate a more nuanced exploration of how suture characteristics influence surgeon
preference, beyond filament type and size, and how makers of suture may better report and
represent these factors.
- Specific eligibility requirements included surgical defects that are linear, without
curvature, 3.0 cm in length or greater and extending into the subcutis or fascia.
- All surgical defects were required to be closed primarily (that is without flaps or
grafts) and had equal skin integrity on both halves of their surgical defects.
- All subjects were capable of providing written informed consent.
- Unable to provide written informed consent